RT Journal Article
SR Electronic
T1 Outcome and prognostic factors of nontuberculous mycobacteriosis in France: A cohort study of 192 patients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4412
VO 42
IS Suppl 57
A1 Claire Andrejak
A1 Olivia Peuchant
A1 Nicolas Veziris
A1 Christine Segonds
A1 Dominique Terru
A1 Farida Hamdad
A1 Aurore Lagrange
A1 Valérie Lalande
A1 Catherine Laurain
A1 Pascale Bemer
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P4412.abstract
AB Background Some skepticism remains on the benefit of antibiotics for nontuberculous mycobacteria (NTM) pulmonary infections. We have conducted a cohort study to estimate outcome and prognostic factors of NTM pulmonary infections in France.Methods. We included all adults of the 18 participating centers in 2009 and 2010 with a diagnosis of NTM pulmonary infection according ATS/IDSA 2007 criteria (MYCOMED network). Survival and prognostic factors were assessed by Cox regression. End point was evolution by September 1st 2012, death or loss of follow-up whichever came first.Results Among the 192 patients included, 117 (61%) were infected with Mycobacterium avium complex (MAC), 36 with M. xenopi (19%), 15 with M. kansasii (7.8%), 13 with rapidly growing mycobacteria (6.8%) and 11 to slowly growing mycobacteria (5.7%). MAC pulmonary infections differed from the others NTM infection: female predominance (57% vs 11% for M. xenopi), lower frequency of chronic respiratory diseases (47% vs 56% for M. xenopi) and a majority (62%) of nodular radiological forms whereas M xenopi infections were equally distributed into cavitary, nodular and infiltrative forms. Overall, two years mortality was 16.4%. Univariate analysis showed a better survival in the MAC group than in the M. xenopi group. Multivariate analysis identified 3 independent predictors of better prognosis: female sex (HR 0.49, p 0.07), nodular radiological form (HR 0.29, p 0.005) and treatment (HR 0.41, p 0.01).Conclusion This cohort study based on routine clinical practice demonstrates a clear benefit of treatment and support the use of antibiotics for NTM pulmonary infections.